EV Neonatal Jaundice
EV Neonatal Jaundice
EV Neonatal Jaundice
Fisiological jaundice
Pathological jaundice
Jaundice in prematures
Frequently
Stage 2
(late step)
Stage 3
(chronic step)
Weakness
Lethargy
Strident cry
Weak sucking reflex
Extensor muscles
Hypertonus
Opisthotonus
Rigidity
Oculogyric crisis
Fever
Seizures
Aathetosis
Partial or complete
Ddeafness
Ataxia
Medium or severe mental
Ddeficiency
Jaundice ethiology
<24 ore
24 ore 14 zile
Rh factor incompatibility
ABO incompatibility
bacterial sepsis
specific infection
spherocytosis
Deficiency of glucose phosphate dehydrogenase
sepsis
Hemolysis
cephalhematoma
intracranial hemorrhage
physiological jaundice
Jaundice to breast milk
conjugated hyperbilirubinemia
- Infection (Hepatitis B, TORCH, sepsis)
- Congenital malformations (biliary
atresia, bile duct cysts, duct stenosis)
- Metabolic Diseases (galactosemia,
fructose intolerance, alpha-1 antitrypsin
deficiency, tyrosinemia, hypothyroidism)
Hemolysis
Jaundice breast milk
clinical evaluation
Jaundice
Pallor
Aholic
stool
Hepato-
splenomegaly
Kramer diagrame
Zone Affected region
100
150
Lower abdomen
200
250
>250
Familiar anamnesis
Pallor
Hepatosplenomegaly
Laboratory examinations
1 day
frequency
2 day
tactics
frequency
3 day
tactics
tactics
BC
monitoring
Visible
jaundice
BT
85-100
3-5 hours
FT
8-12 hours
FT
8-12 hours
monitoring
120-190
3-4 hours
Consilium
FT
4-6 hours
Consilium
FT
6-8 hours
Consilium
FT
200- 250
2-3 hours
Consilium
FT
2-4 hours
FT
4-6 hours
Consilium
FT
EXT
2-3 hours
Consilium
FT
>250
BC
frequency
3-4 hours
Consilium
FT
An
Its possible FT
FT
ExBT and
intensive FT
<24
65
85
100
25-48
12(170)
15 (260)
20 (340)
25 (430)
48-72
15(260)
18 (310)
25 (430)
30 (510)
72
17(290)
20 (340)
25 (430)
30 (510)
120
Indications
for
phototherapy
and exchange
blood
transfusion
ExBT
FT or ExBT initiation
repeat bilirubin or FT
initiation
repeat bilirubin
observation / monitoring
bilirubin
phototherapy
breastfeeding
physiological jaundice
2.
3.
Measure the total serum bilirubin or conjugated bilirubin to a sick child with
jaundice in the first 24 hours
4.
5.
6.
Do not treat the nearterm newborns (35-37 sg) as a term newborn - these
children represent a higher risk of developing hyperbilirubinemia
7.
8.
9.
10.
The neonatal
jaundices treatment
FT
ExBT
Intensive phototheraphy
Phototherapy technology
Phototherapy complications
Frequent stools
Dehydration
Overheating
Skin rashes
Retinal damage
Irritability or lethargy
The formula for calculating the volume required for ExBT (RV)
RV = 2 CBV (circulating blood volume) x M (body mass) in kg
RV consists of 1 part of red blood cells and 2 parts of plasma